CPT® Code 75833

1. Indications

Renal venography is performed for several specific indications, which include:

• Blood Clots The procedure is utilized to identify the presence of thrombus within the renal veins, which can impede blood flow and lead to significant complications.
• Tumors Renal venography aids in the detection of tumors that may be affecting the renal veins or surrounding structures, providing critical information for diagnosis and treatment planning.
• Retroperitoneal Fibrosis This condition involves the formation of fibrous tissue in the retroperitoneal space, which can compress the renal veins. Venography helps in assessing the extent of this compression.
• Renal Agenesis The procedure can assist in diagnosing renal agenesis, a congenital condition where one or both kidneys are absent, by evaluating the vascular structures associated with the kidneys.
• Venous Anomalies Renal venography is useful in identifying any congenital or acquired anomalies of the renal veins that may affect venous drainage.
• Renovascular Hypertension In cases where renovascular hypertension is suspected, this procedure can help determine if renal artery stenosis or other vascular issues are contributing to elevated blood pressure.

2. Procedure

The renal venography procedure involves several critical steps to ensure accurate imaging and assessment of the renal veins:

• Accessing the Femoral Vein The procedure typically begins with the patient positioned appropriately, followed by the identification and access of the femoral vein in either the right or left groin. A large bore needle is used to puncture the vein, allowing for the introduction of a guidewire.
• Threading the Guidewire Once the femoral vein is accessed, a guidewire is carefully threaded through the needle and advanced into the vena cava, which is the large vein that carries blood to the heart. The guidewire is then maneuvered into the renal veins to facilitate further steps.
• Inserting the Catheter A catheter is then threaded over the guidewire to the selected location within the renal veins. This catheter serves as the conduit for the radiopaque contrast medium. After the catheter is in place, the guidewire is removed, leaving the catheter in position for the next step.
• Injecting Contrast Medium With the catheter properly positioned, a radiopaque contrast medium is injected through the catheter. This contrast agent enhances the visibility of the renal veins during imaging.
• Taking X-ray Images As the contrast medium flows through the renal veins, X-ray images are captured. These images allow for the assessment of the renal venous anatomy and any potential abnormalities.
• Removing the Catheter At the conclusion of the imaging study, the catheter is carefully removed from the femoral vein, and appropriate post-procedure care is provided to the patient.

3. Post-Procedure

After the renal venography procedure, patients may be monitored for any immediate complications related to the venous access site. It is essential to assess for signs of bleeding or hematoma formation at the puncture site. Patients are typically advised to rest for a short period and may be instructed to avoid strenuous activities for a specified duration. The results of the venography, including the images obtained and the interpretation of findings, are documented in a written report, which is crucial for guiding further clinical management and decision-making.